Food allergies getting worse - but why?

[significance]

Since childhood, I've been allergic to cherries, getting eczema whenever I eat them. Several years ago, I started getting eczema and generalised itching frequently all summer, and I eventually realised that I was reacting not only to cherries, but also to other stonefruits and related nuts (drupes in general). An immunologist confirmed that my symptoms were consistent with a non ig-E mediated allergy, and probably connected to my verified Birch pollen allergy. Cutting the offending fruit and nuts out of my diet not only got rid of the eczema, but also seemed to fix some recurring gastro-intestinal symptoms (pain and vomiting) that I had not previously connected to an allergy, but which my gastro-enterologist hadn't been able to explain.

The problem is that as I have cut drupes out of my diet, the list of things that I seem to react to is expanding (from cherries to cherries and nectarines, to cherries and nectarines and a few types of nuts, and just recently also olives and coconuts) and my reactions seem to be getting worse when I slip up and eat something I shouldn't: the eczema is not changing, but the oesophogal spasms and vomiting  are happening every time now instead of just sometimes, the subsequent diarrhea is worse, and just recently, I experienced a complete loss of bowel control after eating a curry containing coconut cream. 

Would this be happening anyway, or does cutting allergens out of the diet reduce tolerance and result in stronger reactions when you do eat them?  Apart from restricting my diet more carefully and being more paranoid when eating out, is there anything I can do? And if my reactions seem to be non ig-E and restricted to skin and gastro problems, can I safely assume that they will remain so -- or should I worry that I might one day get a severe analphyactic reaction out of the blue? 

[Macabre]

Judging on symptoms alone, they seem to me IgE-mediated responses. And scary.

[spacecanada]

I would bring this up with your allergist as soon as possible (today/tomorrow!).  These sound like pretty severe allergic reactions.  Fruits and nuts can be related to pollens, and the resulting food allergy can be called oral allergy syndrome or OAS, like your allergist said. Whilst most people with OAS call it an irritating inconvenience, it can turn into serious allergic reactions requiring emergency medical attention.  Throat symptoms, vomiting, and loss of bowel control are all red flags.  You should have an epinephrine auto injector (two, actually) and an allergy action plan.  The only way to stop having reactions is to remove the offending foods from your diet completely.  If your allergist won't cooperate, it may be time to find a new one.

[significance]

Thank you both for the replies and advice. Not what I was hoping to hear, obviously, but from the sound of things, I had better follow up with my doctor.

I didn't discuss the gastro symptoms with the immunologist when I saw him because at that stage, I hadn't connected those issues to the allergy. He diagnosed the eczema as a non IgE on the grounds that I had a negative skin prick test result for the nuts in his test kit and the eczema takes an hour or two to show up, rather than appearing immediately. I don't get the itching or blistering mouth symptoms of OAS (I wish I did - it would be a nice warning!) The oesophogal symptoms and vomiting are usually about half an hour after eating, with diarrhea following the next morning. Is that sort of delay possible with an IgE reaction?

[Macabre]

Yes. It's not common but possible.

[poppie]

Hi there, Have you checked that sulfites arent causing you problems.. as they are in olives, cherries, dried fruits, just a thought....

[lakeswimr]

here is a sample food allergy emergency plan so you can compare your symptoms to those listed. 

https://www.foodallergy.org/document.doc?id=234

Chest pain is also a possible sign of anaphylaxis.

My understanding is that while most eczema is not food related, if it is, then it is IgE mediated.  People who only get eczema as a symptom of a food allergy can often treat the eczema and keep the food in their diet but symptoms beyond just eczema as a result of ingesting a food indicate a more serious IgE allergy that requires epi pens, label reading, great care if going out to eat, and an emergency action plan.

It does sound like your reactions are in the serious IgE realm unfortunately.

Skin and blood testing have a very high accuracy rate for *negative* results at over 90%, but that still leaves not quite 10% false negatives meaning a person can test negative but be allergic.

And false positives are very, very common, unfortunately.  (Just FYI.)

IgE mediated food allergic reactions start within minutes to up to 2 hours after ingestion 99.9% of the time.  Your symptoms fall in that window. 

Another possibility would be eosinophilc esophagitis (EoE).  Here is a link to info about EoE.  http://apfed.org/about-ead/egids/eoe/

Honestly, I am not sure what is going on with you.  If i had to bet, I'd say IgE food allergy but you might want to also look under the EoE rock.  Either way, you need a good allergist and maybe a good GI doctor who know both IgE mediated food allergies and EoE well.  Not all do.